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Cambras T, Pardina E, Carmona J, Ricart-Jane D, Minarro A, Ferrer R, Lecube A, Balibrea JM, Caubet E, González O, Vilallonga R, Cuello E, Fort JM, Baena-Fustegueras JA, Díez-Noguera A, Peinado-Onsurbe J. Seasonal variation of body weight loss after bariatric surgery. Chronobiol Int 2019; 36:672-680. [PMID: 30843440 DOI: 10.1080/07420528.2019.1580716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Seasonal variations have been described in humans in several variables such as sleep, mood, appetite, food preferences, or body weight. We hypothesized that these variations could also influence the decrease in body weight rate in patients submitted to body weight loss interventions. Thus, here we tested the variations of weight loss according to the time of the year the surgery took place in a group patients (n = 1322) submitted to bariatric surgery in the Hospital Universitari de la Vall d'Hebron in Barcelona (geographical coordinates: 41°25'41″N 2°8'32″E). For the analysis, the percentage of total body weight loss (%TWL), excess body weight loss (%EWL) and percentage of body mass index loss (%BMIL) were calculated at 3 (n = 1255), 6 (n = 1172), 9 (n = 1002), and 12 months (n = 1076) after surgery. For %EWL and %BMIL a statistically significant seasonal variation was detected when the variables were calculated at 3 months, but not at the other times, with more weight loss in summer-fall. However, seasonal variations were not detected for %TWL (p = 0.09). The mean amplitude of the seasonal rhythm for %EWL was of 1.8%, while for the rhythm of %BMIL was 0.7%. Moreover, a second peak was detected in January-February modulating the seasonal rhythm of the two variables. Results confirm seasonal variations in humans and indicate that short term responses to weight loss can be modulated by the time of year.
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Affiliation(s)
- Trinitat Cambras
- a Department of Physiology and Biochemistry, Faculty of Pharmacy and Food Sciences , Universitat de Barcelona , Barcelona , Spain
| | - Eva Pardina
- b Department of Biochemistry and Molecular Biomedicine, Faculty of Biology , Universitat de Barcelona , Barcelona , Spain
| | - Julia Carmona
- b Department of Biochemistry and Molecular Biomedicine, Faculty of Biology , Universitat de Barcelona , Barcelona , Spain
| | - David Ricart-Jane
- b Department of Biochemistry and Molecular Biomedicine, Faculty of Biology , Universitat de Barcelona , Barcelona , Spain
| | - Antonio Minarro
- c Department of Genetics, Microbiology and Statistics, Faculty of Biology , Universitat de Barcelona , Barcelona , Spain
| | - Roser Ferrer
- d Department of Biochemistry , Institut de Recerca Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Albert Lecube
- e Department of Endocrinology and Nutrition , Arnau de Vilanova University Hospital, CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM) , Lleida , Spain
| | - Jose María Balibrea
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Enric Caubet
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Oscar González
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Ramón Vilallonga
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Elena Cuello
- g Endocrinology Surgery Unit , Arnau de Vilanova University Hospital (UdL) , Lleida , Spain
| | - Jose Manuel Fort
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | | | - Antoni Díez-Noguera
- a Department of Physiology and Biochemistry, Faculty of Pharmacy and Food Sciences , Universitat de Barcelona , Barcelona , Spain
| | - Julia Peinado-Onsurbe
- b Department of Biochemistry and Molecular Biomedicine, Faculty of Biology , Universitat de Barcelona , Barcelona , Spain
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Cambras T, Pardina E, Carmona J, Ricart-Jané D, Miñarro A, Ferrer R, Lecube A, Balibrea JM, Caubet E, González O, Vilallonga R, Fort JM, Cuello E, Baena-Fustegueras JA, Díez-Noguera A, Peinado-Onsurbe J. Seasonal variations of changes in lipid and glucidic variables after bariatric surgery. Chronobiol Int 2018; 36:250-257. [PMID: 30351989 DOI: 10.1080/07420528.2018.1533560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Seasonality is a phenomenon that is characterized by changes over the year in sleep, mood, behaviour, appetite and body weight. In humans, seasonal variations have been found in certain variables, such as lipid variables and body mass index. We hypothesize that this rhythm could influence the expected variation of the levels of biochemical variables in cases of body weight loss. Thus, the goal of this study was to observe whether the time of year in which bariatric surgery (BS) took place modulated the changes in several variables related to glucidic and lipid metabolism. Blood samples were obtained from 24 women and 10 men before BS and 1 and 3 months after BS. We calculated the percentage of variation that occurred for each individual and for each variable as a function of the time of the year. Data were adjusted to a 12-month period sinusoidal curve, with significance being set at p < 0.05. The results showed that almost all of the studied variables changed due to the BS according to a seasonal rhythm. Most of the variables showed a decrease that was most prominent in winter. In the cases of body mass index (BMI), adrenocorticotropin hormone (ACTH), and cortisol, the highest variation occurred in winter. Insulin and cholesterol in high-density lipoproteins (cHLD) variations were higher in springtime. Glucose variation showed a decrease after surgery with acrophase in summer-fall and plasminogen activator inhibitor-1 (PAI-1) and homeostatic model assessment-insulin resistance (HOMA-IR) in spring-summer. Ghrelin levels showed increases with a rhythm of variation with an acrophase in summer-fall. The seasonal rhythm found in this study fits nearly with the inverse of the endogenous circannual rhythm of the variables studied. The time of the year when the highest variation takes place is related to the circannual rhythm of the variable. The results agree with the manifestation of seasonal rhythm in human biochemical variables, which are reflected in the responses to weight loss after BS.
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Affiliation(s)
- Trinitat Cambras
- a Department of Physiology and Biochemistry, Faculty of pharmacy and Food Sciences , Universitat de Barcelona , Barcelona , Spain
| | - Eva Pardina
- b Department of Biochemistry and Molecular Biomedicine, Biology Faculty , Barcelona University , Barcelona , Spain
| | - Júlia Carmona
- b Department of Biochemistry and Molecular Biomedicine, Biology Faculty , Barcelona University , Barcelona , Spain
| | - David Ricart-Jané
- b Department of Biochemistry and Molecular Biomedicine, Biology Faculty , Barcelona University , Barcelona , Spain
| | - Antonio Miñarro
- c Department of Genetics, Microbiology and Statistics, Biology Faculty , Barcelona University , Barcelona , Spain
| | - Roser Ferrer
- d Department of Biochemistry , Institut de Recerca Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Albert Lecube
- e Department of Endocrinology and Nutrition , Arnau de Vilanova University Hospital, CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM, Spain) , Lleida , Spain
| | - José María Balibrea
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Enric Caubet
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Oscar González
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Ramón Vilallonga
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Jose Manuel Fort
- f Endocrinology Surgery Unit , Hospital Universitari Vall d'Hebron , Barcelona , Spain
| | - Elena Cuello
- g Endocrinology Surgery Unit , Arnau de Vilanova University Hospital (UdL) , Lleida , Spain
| | | | - Antoni Díez-Noguera
- a Department of Physiology and Biochemistry, Faculty of pharmacy and Food Sciences , Universitat de Barcelona , Barcelona , Spain
| | - Julia Peinado-Onsurbe
- b Department of Biochemistry and Molecular Biomedicine, Biology Faculty , Barcelona University , Barcelona , Spain
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Cambras T, Baena-Fustegueras JA, Pardina E, Ricart-Jané D, Rossell J, Díez-Noguera A, Peinado-Onsurbe J. Seasonal variation in plasma lipids and lipases in young healthy humans. Chronobiol Int 2017; 34:1248-1258. [DOI: 10.1080/07420528.2017.1359618] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Trinitat Cambras
- Departament de Fisiologia i Bioquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Barcelona, Spain
| | | | - Eva Pardina
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - David Ricart-Jané
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Joana Rossell
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Antoni Díez-Noguera
- Departament de Fisiologia i Bioquímica, Facultat de Farmàcia i Ciències de l’Alimentació, Universitat de Barcelona, Barcelona, Spain
| | - Julia Peinado-Onsurbe
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
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Pardina E, Ferrer R, Rossell J, Ricart-Jané D, Méndez-Lara KA, Baena-Fustegueras JA, Lecube A, Julve J, Peinado-Onsurbe J. Hepatic CD36 downregulation parallels steatosis improvement in morbidly obese undergoing bariatric surgery. Int J Obes (Lond) 2017; 41:1388-1393. [PMID: 28555086 DOI: 10.1038/ijo.2017.115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 02/28/2017] [Accepted: 04/02/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The notion that hepatic expression of genes involved in lipid metabolism is altered in obese patients is relatively new and its relationship with hepatic steatosis and cardiometabolic alterations remains unclear. OBJECTIVE We assessed the impact of Roux-en-Y gastric bypass surgery (RYGB) on the expression profile of genes related to metabolic syndrome in liver biopsies from morbidly obese individuals using a custom-made, focused cDNA microarray, and assessed the relationship between the expression profile and hepatic steatosis regression. MATERIALS AND METHODS Plasma and liver samples were obtained from patients at baseline and 12 months after surgery. Samples were assayed for chemical and gene expression analyses, as appropriate. Gene expression profiles were assessed using custom-made, focused TaqMan low-density array cards. RESULTS RYGB-induced weight loss produced a favorable reduction in fat deposits, insulin resistance (estimated by homeostasis model assessment of insulin resistance (HOMA-IR)), and plasma and hepatic lipid levels. Compared with the baseline values, the gene expression levels of key targets of lipid metabolism were significantly altered: CD36 was significantly downregulated (-40%; P=0.001), whereas APOB (+27%; P=0.032) and SCARB1 (+37%; P=0.040) were upregulated in response to surgery-induced weight reduction. We also observed a favorable reduction in the expression of the PAI1 gene (-80%; P=0.007) and a significant increase in the expression of the PPARA (+60%; P=0.014) and PPARGC1 genes (+36%; P=0.015). Notably, the relative fold decrease in the expression of the CD36 gene was directly associated with a concomitant reduction in the cholesterol (Spearman's r=0.92; P=0.001) and phospholipid (Spearman's r=0.76; P=0.04) contents in this tissue. CONCLUSIONS For the first time, RYGB-induced weight loss was shown to promote a favorable downregulation of CD36 expression, which was proportional to a favorable reduction in the hepatic cholesterol and phospholipid contents in our morbidly obese subjects following surgery.
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Affiliation(s)
- E Pardina
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - R Ferrer
- Unitat d'Hormones, Servei de Bioquímica, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain
| | - J Rossell
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - D Ricart-Jané
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - K A Méndez-Lara
- Institut de Recerca de l'Hospital de La Santa Creu i Sant Pau, Institut d'Investigacions Biomèdiques de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.,Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - A Lecube
- Departament d'Endocrinologia i Nutrició, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, Lleida, Spain.,Unitat de Recerca en Diabetes i Metabolisme, Institut de Recerca Hospital Universitari Vall d'Hebron, Barcelona, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, Barcelona, Spain
| | - J Julve
- Institut de Recerca de l'Hospital de La Santa Creu i Sant Pau, Institut d'Investigacions Biomèdiques de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.,Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Bellaterra, Spain.,CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, Barcelona, Spain
| | - J Peinado-Onsurbe
- Departament de Bioquímica i Biomedicina Molecular, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
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Baena-Fustegueras JA, Pardina E, Balada E, Ferrer R, Catalán R, Rivero J, Casals I, Lecube A, Fort JM, Vargas V, Peinado-Onsurbe J. Soluble CD40 Ligand in Morbidly Obese Patients. JAMA Surg 2013; 148:151-6. [DOI: 10.1001/jamasurgery.2013.419] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Vargas V, Allende H, Lecube A, Salcedo MT, Baena-Fustegueras JA, Fort JM, Rivero J, Ferrer R, Catalán R, Pardina E, Ramón Y Cajal S, Guardia J, Peinado-Onsurbe J. Surgically induced weight loss by gastric bypass improves non alcoholic fatty liver disease in morbid obese patients. World J Hepatol 2012; 4:382-8. [PMID: 23355916 PMCID: PMC3554802 DOI: 10.4254/wjh.v4.i12.382] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 08/09/2012] [Accepted: 11/14/2012] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the effects of surgical weight loss (Roux-en-Y gastric bypass with a modified Fobi-Capella technique) on non alcoholic fatty liver disease in obese patients. METHODS A group of 26 morbidly obese patients aged 45 ± 2 years and with a body mass index > 40 kg/m(2) who underwent open surgical weight loss operations had paired liver biopsies, the first at surgery and the second after 16 ± 3 mo of weight loss. Biopsies were evaluated and compared in a blinded fashion. The presence of metabolic syndrome, anthropometric and biochemical variables were also assessed at baseline and at the time of the second biopsy. RESULTS Percentage of excess weight loss was 72.1% ± 6.6%. There was a reduction in prevalence of metabolic syndrome from 57.7% (15 patients) to 7.7% (2 patients) (P < 0.001). Any significance difference was observed in aspartate aminotransferase or alanine aminotransferase between pre and postsurgery. There were improvements in steatosis (P < 0.001), lobular (P < 0.001) and portal (P < 0.05) inflammation and fibrosis (P < 0.001) at the second biopsy. There were 25 (96.1%) patients with non alcoholic steatohepatitis (NASH) in their index biopsy and only four (15.3%) of the repeat biopsies fulfilled the criteria for NASH. The persistence of fibrosis (F > 1) was present in five patients at second biopsy. Steatosis and fibrosis at surgery were predictors of significant fibrosis postsurgery. CONCLUSION Restrictive mildly malabsorptive surgery provides significant weight loss, resolution of metabolic syndrome and associated abnormal liver histological features in most obese patients.
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Affiliation(s)
- Víctor Vargas
- Víctor Vargas, Jaime Guardia, Liver Unit, Department of Medicine, Hospital Vall d'Hebron, Universitat Autònoma, 08028 Barcelona, Spain
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Pardina E, Ferrer R, Rivero J, Baena-Fustegueras JA, Lecube A, Fort JM, Vargas V, Catalán R, Peinado-Onsurbe J. Alterations in the common pathway of coagulation during weight loss induced by gastric bypass in severely obese patients. Obesity (Silver Spring) 2012; 20:1048-56. [PMID: 22193919 DOI: 10.1038/oby.2011.361] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The objective of this study was to establish the relationship between the plasminogen activator inhibitor-1 (PAI-1), antithrombin-III (ATIII), fibrinogen, and white blood cell (WBC) levels in severely obese patients. We analyzed various plasma parameters implicated in the intrinsic and extrinsic coagulation pathway from 34 severely obese patients before and 1, 6, and 12 months after gastric bypass. In obese people, ATIII, fibrinogen, and WBC levels were in the upper limit of the normal range, and all were higher and significantly different from nonobese people. After bariatric surgery, the ATIII level continued to be high during the first month and increased until 12 months, while fibrinogen decreased only at that time. PAI-1 plasma protein and PAI-1 mRNA levels in liver and adipose tissue show similar profiles and had a strong positive correlation (r = 0.576, P = 0.0003 in liver; r = 0.433, P = 0.0004 in adipose tissue). They were higher in obese patients compared with nonobese control, but tended to recover normal values 1 month after surgery. Thus, the liver and adipose tissue could be an important source of PAI-1 protein in plasma. Gastric bypass surgery leads to a normalization of the hematological profile and a decrease in PAI-1 levels, which entails a decrease of risk for thromboembolism in severely obese.
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Affiliation(s)
- Eva Pardina
- Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Barcelona, Spain
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Miranda M, Ceperuelo-Mallafré V, Lecube A, Hernandez C, Chacon MR, Fort JM, Gallart L, Baena-Fustegueras JA, Simó R, Vendrell J. Gene expression of paired abdominal adipose AQP7 and liver AQP9 in patients with morbid obesity: relationship with glucose abnormalities. Metabolism 2009; 58:1762-8. [PMID: 19615702 DOI: 10.1016/j.metabol.2009.06.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2009] [Revised: 06/03/2009] [Accepted: 06/16/2009] [Indexed: 11/26/2022]
Abstract
The trafficking of glycerol from adipose and hepatic tissue is mainly mediated by 2 aquaporin channel proteins: AQP7 and AQP9, respectively. In rodents, both aquaporins were found to act in a coordinated manner. The aim was to study the relationship between adipose AQP7 and hepatic AQP9 messenger RNA expression and the presence of glucose abnormalities simultaneously in morbid obesity. Adipose tissue (subcutaneous [SAT] and visceral [VAT]) and liver biopsies from the same patient were obtained during bariatric surgery in 30 (21 male and 9 female) morbidly obese subjects. Real-time quantification of AQP7 in SAT and VAT and hepatic AQP9 gene expression were performed. A 75-g oral glucose tolerance test was performed in all subjects. The homeostasis model assessment of insulin resistance and lipidic profile were also determined. Visceral adipose tissue AQP7 expression levels were significantly higher than SAT AQP7 (P = .009). Subcutaneous adipose tissue AQP7 positively correlated with both VAT AQP7 and hepatic AQP9 messenger RNA expression (r = 0.44, P = .013 and r = 0.45, P = .012, respectively). The correlation between SAT AQP7 and liver AQP9 was stronger in intolerant and type 2 diabetes mellitus subjects (r = 0.602, P = .011). We have found no differences in compartmental AQP7 adipose tissue distribution or AQP9 hepatic gene expression according to glucose tolerance classification. The present study provides, for the first time, evidence of coordinated regulation between adipose aquaglyceroporins, with a greater expression found in visceral fat, and between subcutaneous adipose AQP7 and hepatic AQP9 gene expression within the context of human morbid obesity.
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Affiliation(s)
- Merce Miranda
- Unitat de Recerca, Hospital Universitari de Tarragona Joan XXIII, IISPV, 43007 Tarragona, Spain.
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Pardina E, Baena-Fustegueras JA, Llamas R, Catalán R, Galard R, Lecube A, Fort JM, Llobera M, Allende H, Vargas V, Peinado-Onsurbe J. Lipoprotein lipase expression in livers of morbidly obese patients could be responsible for liver steatosis. Obes Surg 2009; 19:608-16. [PMID: 19301078 DOI: 10.1007/s11695-009-9827-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Accepted: 03/10/2009] [Indexed: 01/09/2023]
Abstract
BACKGROUND Most patients with morbid obesity develop non-alcoholic fatty liver disease (NAFLD). The origins of lipid deposition in the liver and the effects of bariatric surgery in the obese with NAFLD are controversial. METHODS We analyzed lipids and lipoprotein lipase (LPL) in both plasma and liver biopsies performed before and 12-18 months after Roux-en-Y gastric bypass surgery in 26 patients. RESULTS In the livers of morbidly obese patients, the levels of LPL messenger RNA (mRNA) were higher (4.5-fold) before surgery than afterwards than control livers. In these patients, LPL activity was also significantly higher (91 +/- 7 mU/g) than in controls (51 +/- 3 mU/g, p = 0.0026) and correlated with the severity of the liver damage. All hepatic lipids were significantly increased in obese patients; however, after bariatric surgery, these lipids, with the exception of NEFA, tended to recover to normal levels. CONCLUSIONS The liver of obese patients presented higher LPL activity than controls, and unlike the controls, this enzyme could be synthesized in the liver because it also present LPL mRNA. The presence of the LPL activity could enable the liver to capture circulating triacylglycerides, thus favoring the typical steatosis observed in these patients.
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Affiliation(s)
- Eva Pardina
- Biochemistry and Molecular Biology Department, Biology Faculty, Barcelona University, Diagonal 645, 08028, Barcelona, Spain
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Pardina E, Baena-Fustegueras JA, Catalán R, Galard R, Lecube A, Fort JM, Allende H, Vargas V, Peinado-Onsurbe J. Increased expression and activity of hepatic lipase in the liver of morbidly obese adult patients in relation to lipid content. Obes Surg 2008; 19:894-904. [PMID: 18972174 DOI: 10.1007/s11695-008-9739-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 09/23/2008] [Indexed: 11/24/2022]
Abstract
BACKGROUND The types and sources of lipid deposition in the liver of most patients with morbid obesity, as well as the effects of bariatric surgery, are discussed. METHODS In 26 patients with morbid obesity who underwent bariatric surgery, we analyzed different kinds of lipids and hepatic lipase (HL) from both plasma and liver biopsies performed 12-18 months after surgery. RESULTS The HL activity and HL-mRNA in morbidly obese (MO) livers were high (258 +/- 17 mU/g, and 4.5-fold, respectively); after surgery, the activity decreased (137 +/- 15 mU/g, p < 0.001) but not the levels of HL-mRNA (4.3-fold). Plasma HL activity was also high (4.31 +/- 0.94 mU/mL plasma), and it decreased during weight loss (2.01 +/- 0.29 mU/mL, p < 0.01); moreover, it correlated (r = 0.3694, p < 0.05) with decreased liver HL activity. Adrenocorticotropic hormone in MO was higher (27 +/- 3 pg/mL) than after surgery (13 +/- 1 pg/mL, p < 0.001). All hepatic and plasma lipids were significantly increased in MO patients, but, after bariatric surgery, most of those parameters recovered or normalized. Liver HL activity correlated with total and esterified cholesterol (r = 0.4399, p < 0.001 and r = 0.4395, p < 0.01, respectively). CONCLUSION High HL in MO patients could allow for liver intake of cholesterol that could be re-exported to steroidogenic organs to synthesize steroidal hormones. A decrease of plasma HL during weight loss could be a good index for improvement of liver disease.
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Affiliation(s)
- Eva Pardina
- Department of Biochemistry and Molecular Biology, University of Barcelona, Diagonal 645, 08028, Barcelona, Spain
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López Hellín J, Baena-Fustegueras JA, Sabín-Urkía P, Schwartz-Riera S, García-Arumí E. Nutritional modulation of protein metabolism after gastrointestinal surgery. Eur J Clin Nutr 2007; 62:254-62. [PMID: 17375114 DOI: 10.1038/sj.ejcn.1602732] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The metabolic response to surgery includes alterations in protein metabolism, resulting in a net loss of proteins. Protein hypercatabolism is considered an unavoidable consequence of injury, and an important source of morbidity and mortality. Our purpose was to determine the effect of nutrition on protein metabolism following gastrointestinal surgery, and to elucidate whether postoperative protein loss can be prevented with adequate nutritional support. METHODS Patients who had undergone gastrointestinal surgery were given four different parenteral nutritions with increasing glucose, lipid and amino acid content during the 7 days following surgery. Nitrogen balance, protein synthesis and protein breakdown were determined using in vivo stable isotope labelling. Other metabolites (3-methylhistidine, creatinine, urea, cortisol, glucose, insulin, amino acids and C-reactive protein) were measured. RESULTS A nutrition-dependent alteration of protein metabolism was found in response to surgical injury. Nutrition modified nitrogen balance, whole-body protein breakdown and, to a lesser extent, whole-body protein synthesis and muscle protein breakdown. The low-energy parenteral nutrition without amino acids produced a negative nitrogen balance (postoperative day 7=-0.381 g protein kg(-1)day(-1)) and important alterations in postoperative protein metabolism that did not normalize during the study period (day 7 protein synthesis=239% and protein breakdown 217% vs preoperative). Patients receiving the two low energy parenteral nutritions containing amino acids had a less negative nitrogen balance (day 7=-0.011 and -0.133 g protein kg(-1)day(-1)) and a transient increase in protein metabolism. The complete parenteral nutrition maintained, during all studied days, protein metabolism parameters within the preoperative reference range (synthesis day 2=92%, day 4=110% day 7=79%; breakdown day 2=85%, day 4=80%, day 7=76% vs preoperative) and a positive nitrogen balance (day 2=+0.0387, day 4=+0.578 and day 7=+0.227 g protein kg(-1)day(-1)). CONCLUSION Complete nutritional support can prevent protein loss after gastrointestinal surgery and maintain protein metabolism without alterations.
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Affiliation(s)
- J López Hellín
- IBBIM-Institut de Recerca, Hospital Vall d'Hebron, Barcelona, Spain.
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López-Hellin J, Baena-Fustegueras JA, Schwartz-Riera S, García-Arumí E. Usefulness of short-lived proteins as nutritional indicators surgical patients. Clin Nutr 2002; 21:119-25. [PMID: 12056783 DOI: 10.1054/clnu.2001.0515] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIMS Biochemical indicators are used to assess the adequacy of nutritional support given to postoperative patients. However, the metabolic alterations present in these patients diminish the efficiency of these indicators. The objective of this work is to determine the usefulness of short-lived proteins as indicators to assess the nutritional support administered to patients during the metabolic stress phase produced by surgery. METHODS The nitrogen balance and plasma concentrations of transthyretin, retinol binding protein, and insulin-like growth factor-1 were determined in 24 patients who received 4 different nutritional regimens during 7 days after surgery. RESULTS Transthyretin and retinol binding protein, although sensitive to nutritional intake (P<0.0005 and P<0.04 respectively), were strongly affected by the stress response (P<0.008 and P<0.0003 respectively), thus limiting their usefulness for nutrition assessment. Insulin-like growth factor-1 was not influenced by the stress response and was sensitive to the nutritional supply (P<0.0001). Insulin-like growth factor-1 was the only component that showed similar efficiency than nitrogen balance as nutritional indicator. CONCLUSIONS Transthyretin and retinol binding protein are not adequate to assess the nutritional supply during the stress phase after surgery, while insulin-like growth factor-1 is a suitable indicator of the adequacy of recent intake in this situation, similar in performance to nitrogen balance.
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Affiliation(s)
- J López-Hellin
- Centre d'Investigacions en Bioquímica i Biologia Molecular, Vall d'Hebron, Barcelona, Spain
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